Speech by Dr Amy Khor, Senior Minister of State for Health, at the Launch of Next Age Institute, on 23 February 2015

Distinguished Guests, 

Ladies and Gentlemen,

1.            Good Morning. I would like to wish everyone a happy Chinese New Year and a prosperous Year of the Goat. I am delighted to join you this morning at the official launch of Next Age Institute, an academic partnership between the National University of Singapore and Washington University in St. Louis.

Background

2.            The Next Age Institute has been set up to examine complex social issues, as well as design and test social innovations for an ageing population. This is timely as Singapore’s population will age at a more rapid pace in the next one to two decades. This is a trend mirrored in many Asian countries. In 2000, the average age in Asia was 29 years old, and an estimated 6% of the region’s total population were aged 65 and older. By 2050, the proportion of those 65 and older will rise to 18% and the average age in Asia will be 40 years old.[1] As a result, Asia is set to become the oldest region in the world. In general, East Asian countries have higher proportions of seniors today, followed by Southeast Asia and then South Asia.

Ageing and its Impact

3.            Ageing is a key demographic challenge facing us and will have deep impact on our society. In countries such as France, Sweden and the United States saw their proportion of seniors aged 65 years and above doubled from 7% to 14% over 60 years. In comparison, many Asian countries, including Singapore are facing the same progression in less than 30 years. As such, Asian countries have less time to prepare for ageing.

4.            A rapidly ageing population will undoubtedly present some challenges. For instance, an ageing population will place an increasing burden on our national healthcare system. At the same time, our old age support ratio is falling and elderly parents will be increasingly dependent on a smaller number of adult children. The decline in our old age support ratio has a profound impact on the traditional family support system for the elderly both in terms of retirement adequacy as well as the affordability of long-term care.

5.            However, ageing also reflects longevity and presents opportunities. In 1965, our average life expectancy was only 65 years old. Today, the average life expectancy is 83 years[2]. While science and technology has added more life years, the challenge for us is to innovate new ways to translate these additional years in lifespan to healthy and productive years of life. If we fail, then the challenges of an ageing society will deepen and we will not be able to capitalise on the opportunities that it can present.

Ageing Research

6.            Therefore, there is immense scope for exciting research and innovation in ageing. Let me highlight a few areas. Firstly, there can be innovations in extending health span. There can be exciting research into whether and how we can extend seniors’ physical and mental health span. This would require not only innovations in clinical science but also the application of behavioural science to change habits and seniors’ health behaviour. There is also scope to explore how IT can be leveraged on to enable early screening or better health management.

7.            An example of how we have tried to encourage healthy behaviours in seniors is through the Self-Care on Health of Older Persons in Singapore, or SCOPE for short, programme in Whampoa. SCOPE comprises a 24-week programme where seniors are trained in topics such as stress management, positive thinking, physical care and chronic disease management. After the training programme, the seniors have continued to meet at the Whampoa Gardens Residents’ Committee Centre on a weekly basis to share and encourage one another to lead healthier lifestyles, usually over a pot of healthy soup or dish.

8.            Another example of how we have leveraged on IT is the tele-rehabilitation programme under the National University of Singapore. The team from NUS has started conducting clinical trials with patients from Ang Mo Kio-Thye Hua Kwan Hospital and SGH since last year, during which iPads are used to guide patients through exercises on videos, with data captured on motion sensors. In such home-based tele-rehabilitation programmes, the caregivers do not need to accompany the patients to the rehabilitation centre and their therapists do not need to visit them at home to provide rehabilitation, thereby saving precious travel time.

9.            Secondly, there can be innovations in care models. Research can be done on how we can provide more effective and appropriate care for an ageing population, and how these new models can be applied in our current healthcare system. An example of how we have taken a step in this direction is Khoo Teck Puat Hospital’s Ageing in Place (AIP) Programme. In the AIP Programme, community nurses visit the Frequent Admitters (i.e.  patients who are readmitted into the hospital at least three times in six months) in their homes to check not only on their health conditions but also their home and living environment to make sure that it is safe and conducive for the seniors to recover. The community nurses also provide seniors and their family members with the necessary information and health advice to manage their condition well at home.

10.         Thirdly, there can be innovations in urban planning and urban mobility. There is a lot of scope for research on how we can evolve our cities and hardware to meet the changing needs of an ageing population and enable our seniors to live autonomously, actively and gracefully in place for as long as possible. One example of a ground-up innovation is Singhealth’s senior-friendly guide for its healthcare institutions. Singhealth surveyed 380 elderly patients, their family members, as well as staff and clinicians on the age-friendliness of Singhealth’s outpatient clinics over a four-month period in 2011. Based on their findings, Singhealth developed specific principles and guidelines on how their healthcare institutions can be designed to make them more senior-friendly. These principles have since been applied to its new polyclinic at Geylang.

Living Laboratory

11.         While I have outlined three possible areas of research and innovation in ageing along with some examples, we certainly do not have all the answers, and there are more innovative and pioneering work that needs to be done on the multi-faceted aspects of ageing. For research on ageing to have significant impact, it needs to be multi-disciplinary, as well as draw on international comparisons and best practices, but solutions need to be tailored for our local context.

12.         To this end, we hope to see different institutions coming together to conduct research on ageing, such as how NUS and Washington University have done in the setting up of Next Age Institute. Another way for different disciplines to come together is through doing applied research in living laboratories. An example of this is Marine Parade, which is the first of our City For All Ages (CFAA) pilot precincts. Since its inception as a CFAA pilot site, Marine Parade has been an incubator of a range of programmes and policies, such as senior-friendly home retrofits and a sensor-enabled home monitoring system for seniors living alone.

Conclusion

13.         I am indeed heartened that the Next Age Institute (NAI) will be embracing a trans-disciplinary platform in its deliberation on aging and other complex social issues and embarking on testing new social innovative ideas. I believe that it will provide an excellent platform for academics from the different disciplines, as well as policy makers and students to have discussions on complex issues and to work together to test out new ideas.

14.         I wish NAI success in this endeavour, and look forward to NAI’s contributions to building new knowledge and ideas in the field of ageing. I also wish all of you have a fruitful discussion at this conference. 
 

[1] The Future of Population in Asia: Asia’s Ageing Population. https://www.eastwestcenter.org/fileadmin/stored/misc/FuturePop08Aging.pdf

^[2] Population Trends 2014, Department of Statistics.